Laserfiche WebLink
VES/ APPLICATION FOR WEWPUMP PERMIT <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,STOCKTON,CA 95202 <br /> (209)468-3420 <br /> 116N IIEFUNDASLQP_ESMIT EXPIRES 1 YEAR FROM DATE ISSUED <br /> momp Fts IR Mp"eF1El <br /> APFICATION OR INR!RY MADE 10?Olt RAN JOAO"COUNTY FOR A PEII.OT TO CONSTRUCT AND/OR INSTALL TNI VMW DE@CRMt[T.THSR AMOCAtION IS MADE DI COMPLIANCE WIT11 ANI <br /> JOAOUM COUNTY UEVEtOMEM TT„tl,CHAPTER 2.1119,3 AND <br /> 1Vitt.11TANDARDR OF ROAN JDAOIIIN COURt.YPIRILIIC IIEAL111 RERVIC10..SEMMIONFAEMAL IIEALTII OOARWN. <br /> "It AODIIERRKIR APN. D lu,-P 5r A—Y�7!! 1�E/�CITY 1 l!"Trl ��1T PAM:Et OR TIAPROO <br /> ONFIFA'E NAWva <br /> ADKR1E99 '7�G- GU « �i+,tl�/J a nm m. <br /> coN7RACTOn AINIMPR SOUS Aliezz, GV/ Lx:£ <br /> RVReoMRAeroR <br /> AM-F, ADDRESS r (Ic.p PIONS <br /> Im <br /> oFLVEI CJ NEWWtLt [3 RE/YACIMEM W11L MD1xroRlNewtu/ ��otNE���` <br /> ❑IILSTALLATION C)WELL EYRTEM MPAIA ©CMRRCONMCT FNPAUI ❑VAPOR EXTRACTION WELL I <br /> ❑ RN.T. OEPt11 PUMP RtT___,FT. TRST WATER tEKI <br /> DYm of FVMP .PW <br /> CI ❑nEanIVCICMwELLJ RORRo1RNp R <br /> ❑OE 01TIRICTION: <br /> O Uskcomalmucliom F CIRC s A <br /> 7 <br /> ❑iNOIl9TRAl ❑OPEN RDrtON INA.OF WWII EXCAVATION DIA.OF CONDUCTOR CAtIR10 O <br /> ❑DOMIRTICUT9VATF. 0DRAYEt PACRRQE TYm OF CARRIOIRIEEUPVC DIA.OF WEtt CARING O <br /> LCI P M-)CRJUNRCIPAt ❑GROUCH mm”Of GROW RE At /�i-hr i -me- - ��-- R <br /> LJ IM 3AT10N1A0 OT1[R ORDUt am R1tTALLFO NY �// �" GROUT MtAP, NAME V <br /> 1''t £ <br /> ja F.,OMfamm OnoVT REM PUMPFO:1 3 Y- 1� CONCRETE mOEETAL RY DMU.0:❑Yw ON. S <br /> AP/WOX.of"" �1 LockRIO"IffelfR RpXnTove Ps'Ej R <br /> moroswe CON9T111/01ION10R171N0 MEtNaD:MUD ROTARY AIR ROTARY BL <br /> AUDER CAE OtNER _!' Ltf8 <br /> 1 I4FIWOY CERTRY TIAT I IIAW POWPA1IE0 TMs APPLICATION AND TIIAT TIM WOW WILL RF.DONE 011 ACCORIANCI WTN RAN JOA0UfH COUNTY OIININANCE9.STATE LAW@.AND RULER ANO <br /> DFOIILATIOWR OF 71%RAN JOA"COUNTY,NONE OWNLR tlR LICENEfO A(IF.M'9 FIOHAIURE CFRTIFIE@ 7111 r0110WIN0!'1 CFRTWY THAT M THE ml►ORA/AIIOE OF TUE WORK FOR mffCIt <br /> TORR"RANT R MRUE0.1 WALL Not"Amoy mimm)" URJECW IO WDR01NIAN'E COMPlN@ATOR LAVA OF CALR0IMA:COMRACTOR'R NRRNO OR RURCOMRACTRIO 9IONATVRE CETITNS <br /> TIM FOLLOWNM: '1 CETNY THAT NI TIM PERFORMANCE Of SIR WORK FOR WIOCH 11019"t"Uff IR RSUEb,I 111Att EMPLOY PERSONR EI/IJECT TO WOR01RIAN'l COMrWOATON LAWS Or <br /> CAUFORMA.' TINE ANT MUST GA U HOLM IN ADVANCE FOR Atl REIJIARiD MAVft7NSN.AT 0"1409-104".COMFIT!VRAWRIO AT 1OV2R AREA nIONp D, <br /> mvF x <br /> G TDI.�O�I[57G' e.. / 27/q <br /> FLOW PAN w—1.9.x.1 9.a. ON,- <br /> "All <br /> •N,"All OF STttETI OR MADE WEARERT f0 On ROU110N10 TINE nOmn". 4.LOCATION Or 1101)SE SEWAGE bNOM&AL SYRTFM OR PROP0E[D <br /> !.OUTLINE OF 711E PROPERTY.OIVRMI omn"IOHP A"NORTH mmem". IXPAMMU OF SEWAGE 119POSAL SYE7EMS, <br /> O.bNARNRIONED OWLINIA AND LOCATION OF ALL EXfir"NO ANO PIDM*tb E.LOCATION pF YYFLLs NTt/1011 RAdVE OF OM/RDIDR[O SOFTY FT. <br /> RTRUCIUMs,NCLUDINO COVEBED AFMAI IMM M PATDE,D VEWAYs,AND WAIxI. OR TNF"UNINTY OR ADJONOW FIDFIRTY. <br /> DJTMTMINT URE ONLY <br /> APPSP.11,m A..w1.f it e•I. �� ----A— <br /> Sr b•I. P.*.I.wP..Il.n 01r O.1. <br /> C.mmwAr. <br /> 3 00 <br /> ACCOUNfINO ONt►: AMP SAC! <br /> FE COOEE FEL'INIo AMOUNT REMITTED CM;eXTCAsff REcDVEO I DATE "MIMERNCERIOUEST NVNEfIt INVOICF <br /> Pub 1+eRRh SRrv.•F.nviro.173(11D 7) <br />